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Hepatocellular carcinoma: Epidemic and treatment

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Abstract

Hepatocellular carcinoma remains a worldwide epidemic. Survival rates are poor; however, oncologists are able to offer regional therapies to those patients who present with early disease. Prevention through vaccination remains a mainstay of this epidemic. New staging systems that incorporate important information about tumor characteristics and liver disease improve our ability to prognosticate and treat these patients.

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References and Recommended Reading

  1. Globocan 2000: Incidence, Mortality and Prevalence Worldwide, Version 1.0. IARC Cancer Base No. 5. Lyon, France: IARC Press; 2001.

    Google Scholar 

  2. Centers for Disease Control: Hepatitis B virus: a comprehensive strategy for eliminating transmission in the US through universal childhood vaccination: recommendations of the Immunization Practices Advisory Committee (ACIP). Morbid Mortal Weekly Rep 1991, 40:RR-13.

    Google Scholar 

  3. National Cancer Institute: SEER Cancer Statistics Review 1975–2000. http://www.seer.cancer.gov.

  4. Rasi G, Pierimarchi P, Sinibaldi Vallebona P, et al.: Combination therapy in the treatment of chronic viral hepatitis and prevention of hepatocellular carcinoma. HCC. Int Immunopharmacol 2003, 3:1169–1197.

    Article  PubMed  CAS  Google Scholar 

  5. Yu MC, Yuan JM, Govindarajan S, Ross RK: Epidemiology of hepatocellular carcinoma. Can J Gastroenterol 2000, 8:703–709.

    Google Scholar 

  6. Lee W: Hepatitis B infection. N Engl J Med 1997, 337:1733–1745.

    Article  PubMed  CAS  Google Scholar 

  7. Maddrey W: Hepatitis B-an important public health issue. Clin Lab 2001, 47:51–55.

    PubMed  CAS  Google Scholar 

  8. El Sarag HB: Hepatocellular carcinoma and Hepatitis C in the United States. Hepatology 2002:574–583.

  9. Alter MI: Epidemiology of hepatitis C. Hepatology 1997, 26(Suppl 1):62s-65s.

    Article  PubMed  CAS  Google Scholar 

  10. Centers for Disease Control. http://www.cdc.gov/ncidod/ diseases/hepatitis/b/fact.htm: 2003.

  11. Davila JA, Petersena NJ, Nelson HA, El-Serag HB: Geographic variation within the United States in the incidence of hepatocellular carcinoma. J Clin Epidemiol 2003, 5:487–493.

    Article  Google Scholar 

  12. Wong JB, McQuillan GM, McHutchison JG, Poynard T: Estimating future hepatitis C morbidity, mortality and costs in the U.S. Am J Public Health 2000, 90:1562–1569.

    PubMed  CAS  Google Scholar 

  13. Montalto G, Cervello M, Giannitrapani L, et al.: Epidemiology, risk factors, and natural history of hepatocellular carcinoma. Ann N Y Acad Sci 2002, 963:13–20.

    Article  PubMed  Google Scholar 

  14. Centers for Disease Control and Prevention: Global progress toward universal childhood hepatitis B vaccination, 2003. Morbid Mortal Weekly Rep 2003, 52:868–870.

    Google Scholar 

  15. Bruix J, Llovet J: Prognostic prediction and treatment strategy in hepatocellular carcinoma. Hepatology 2002, 35:519–524.

    Article  PubMed  Google Scholar 

  16. Llovet JM, Bru C, Bruix J: Prognosis of hepatocellular carcinoma: the BCLC staging classification. Semin Liver Dis 1999, 19:329–338. This proposed staging system combines characteristics of HCC and underlying liver disease relevant to the medical oncologist for prognosis and therapy.

    Article  PubMed  CAS  Google Scholar 

  17. Llovet JM, Real MI, Montana X, et al.: Arterial embolization, chemoembolization versus symptomatic treatment in patients with unresectable hepatocellular carcinoma: a randomized controlled trial. Lancet 2002, 359:1734–1741. This study demonstrates a survival advantage for a subset of patients treated with chemoembolization.

    Article  PubMed  Google Scholar 

  18. Varela M, Sala M, Llovet JM, Bruix J: Natural history and prognostic prediction of patients with HCC. Aliment Pharmacol Ther 2003, 17(Suppl 2):98–102.

    Article  PubMed  Google Scholar 

  19. Cancer of the Liver Italian Program Investigators: A new prognostic system for hepatocellular carcinoma: a retrospective study of 435 patients. Hepatology 1998, 28:751–755. This proposed staging system combines characteristics of HCC and underlying liver disease relevant to the medical oncologist for prognosis and therapy.

    Article  Google Scholar 

  20. Prospective validation of the CLIP score: a new prognostic system for patients with cirrhosis and HCC. The Cancer of the Liver Italian Program Investigators. Hepatology 2000, 31:679–680.

  21. Leung TW, Tang AM, Zee B, et al.: Construction of the Chinese University Prognostic Index for hepatocellular carcinoma and comparison with the TNM staging system, the Okuda staging system, and the CLIP staging system. Cancer 2002, 94:1760–1769.

    Article  PubMed  Google Scholar 

  22. Varela M, Sala M, Llovet JM, Bruix J: Treatment of hepatocellular carcinoma: Is there an optimal strategy? Cancer Treat Rev 2003, 29:99–104.

    Article  PubMed  Google Scholar 

  23. Yoo HY, Patt CH, Geschwind JF, Thuluvath PJ: The outcome of liver transplantation in patients with hepatocellular Carcinoma in the United States Between 1988 and 2001: 5-year survival has improved significantly with Time. J Clin Oncol 2003, 21:4329–4335. A comprehensive review of liver transplant outcomes in over 33,000 patients with HCC.

    Article  PubMed  Google Scholar 

  24. Sonoyama T, Ochiai T, Hironaka T, Yamagishi H: Predictors of postoperative diffuse intrahepatic recurrence of hepatocellular carcinoma. Hepatogastroenterology 2003, 50:1078–1084.

    PubMed  Google Scholar 

  25. Vauthey JN, Lauwers GY, Esnaola NF, et al.: Simplified staging for hepatocellular carcinoma. J Clin Oncol 2002, 15:1527–1536.

    Article  Google Scholar 

  26. Hemming AW: Liver transplantation for hepatocellular carcinoma. Ann Surg 2001, 233:652–659.

    Article  PubMed  CAS  Google Scholar 

  27. Yao F: The Impact of expansion of conventional tumor criteria and pre-operative loco-regional treatments on survival following liver transplantation for hepatocellular carcinoma: results from two centers. Presented at the annual meeting of the American Association for the Study of Liver Diseases, Boston, MA, October 24–28, 2003; abstract 3.

  28. Chao Y, Li CP, Chau GY, et al.: Prognostic significance of vascular endothelial growth factor, basic fibroblast growth factor, and angiogenin in patients with respectable HCC after surgery. Ann Surg Oncol 2003, 10:355–362.

    Article  PubMed  Google Scholar 

  29. Baffis V, Shrier I, Sherker AH, Szilagyi A: Use of interferon for prevention of HCC in cirrhotic patients with hepatitis B or hepatitis C virus infection. Ann Intern Med 1999, 31:696–701.

    Google Scholar 

  30. Yao F: Dramatic reduction of the AFP level after lamivudine treatment of patients with chronic hepatitis B virus infection and cirrhosis. J Clin Gastroenterol 2003, 36:440–442.

    Article  PubMed  CAS  Google Scholar 

  31. National Cancer Institute: Hepatocellular Cancer (PDQ): Screening. http://www.nci.nih,gov/cancerinfo/pdq. Last updated June 2003.

  32. Bruix J, Sherman M, Llovet JM, et al.: Clinical management of hepatocellular carcinoma: conclusions of the Barcelona-2000 EASL Conference. J Hepatol 2001, 35:42:1–430.

    Google Scholar 

  33. Bolondi L, Sofia S, Siringo S, et al.: Surveillance program of cirrhotic patients for early diagnosis and treatment of hepatocellular carcinoma: a cost-effectiveness analysis. Gut 2001, 48:251–259.

    Article  PubMed  CAS  Google Scholar 

  34. Nguyen MH, Keeffe EB: Screening for hepatocellular carcinoma. J Clin Gastroenterol 2002, 35(Suppl 2):S86-S91.

    Article  PubMed  CAS  Google Scholar 

  35. Mela M, Mancuso A, Burroughs AK: Hepatocellular carcinoma: indications for liver transplantation. Aliment Pharmacol Ther 2003, 17(Suppl 2):130–137.

    Article  PubMed  Google Scholar 

  36. Yao FY, Bass NM, Nikolai B, et al.: Liver transplantation for hepatocellular carcinoma: analysis of survival according to the intention-to-treat principle and dropout from the waiting list. Liver Transpl 2002, 8:873–883.

    Article  PubMed  Google Scholar 

  37. Kamath PS, Wiesner RH, Malinchoc M, et al.: A model to predict survival in patients with end-stage liver disease. Hepatology 2001, 22:464–470.

    Article  Google Scholar 

  38. Mazzaferro V, Regalia E, Doci R, et al.: Liver transplantation for the treatment of small hepatocellular carcinomas in patients with cirrhosis. N Engl J Med 1996, 334:693–699. Establishes criteria for liver transplant in patients with HCC.

    Article  PubMed  CAS  Google Scholar 

  39. Venook AP, Ferrell LD, Roberts JP, et al.: Liver transplantation for hepatocellular carcinoma: results with preoperative chemoembolization. Liver Transpl Surg 1995, 1:242–248.

    Article  PubMed  CAS  Google Scholar 

  40. Yao FY, Ferrell L, Bass NM, et al.: Liver transplantation for hepatocellular carcinoma: expansion of the tumor size limits does not adversely impact survival. Hepatology 2001, 33:1394–1403.

    Article  PubMed  CAS  Google Scholar 

  41. Marsh JW, Dvorchik I, Bonham CA, Iwatsuki S: Is the pathologic TNM staging system for patients with hepatoma predictive of outcome? Cancer 2000, 89:2266–2273.

    Article  Google Scholar 

  42. Yao FY, Ferrell L, Bass NM, et al.: Liver transplantation for hepatocellular carcinoma: comparison of the proposed UCSF criteria with the Milan criteria and the Pittsburgh modified TNM criteria. Liver Transpl 2002, 8:765–774. Proposed expanded criteria for liver transplant in patients with HCC.

    Article  PubMed  Google Scholar 

  43. Aqel BA, Gores G, Steers J, et al.: Expanding the selection criteria for transplant patients with hepatocellular carcinoma: a world of caution. Presented at the annual meeting of the American Association for the Study of Liver Diseases, Boston, MA, October 24–28, 2003; abstract 1238.

  44. Cavazzoni E, Meehan MD, Shackleton C, et al.: Pre-transplant adjuvant therapy for hepatocellular carcinoma results in a survival disadvantage. Presented at the annual meeting of the American Association for the Study of Liver Diseases, Boston, MA, October 24–28, 2003; abstract 1241.

  45. Llovet JM, Fuster J, Bruix J: Intention-to-treat analysis of surgical treatment for early hepatocellular carcinoma: resection versus transplantation. Hepatology 1999, 30:1434–1440.

    Article  PubMed  CAS  Google Scholar 

  46. Sarasin FP, Majno PE, Llovet JM, et al.: Living donor liver transplantation for early hepatocellular carcinoma: a lifeexpectancy and cost-effectiveness perspective. Hepatology 2001, 33:1073–1079.

    Article  PubMed  CAS  Google Scholar 

  47. Lo CM, Ngan H, Tso WK, et al.: Randomized controlled trial of transarterial lipiodol chemoembolization for unresectable hepatocellular carcinoma. Hepatology 2002, 35:1164–1171.

    Article  PubMed  CAS  Google Scholar 

  48. Galandi D, Antes G: Radiofrequency thermal ablation versus other interventions for hepatocellular carcinoma. Cochrane Database Syst Rev 2002, 3:CD003046.

    PubMed  Google Scholar 

  49. Gaiani S, Celli N, Cecilioni L, et al.: Percutaneous treatment of hepatocellular carcinoma. Aliment Pharmacol Ther 2003, 17(Suppl 2):103–110.

    Article  PubMed  Google Scholar 

  50. Bolondi L, Piscaglia F, Camaggi V, et al.: Liver transplantation for hepatocellular carcinoma: treatment options on the waiting list. Aliment Pharmacol Ther 2003, 17(Suppl 2):145–150.

    Article  PubMed  Google Scholar 

  51. Takayama T, Sekine T, Makuuchi M, et al.: Adoptive immunotherapy to lower postsurgical recurrence rates of hepatocellular carcinoma: a randomized trial. Lancet 2000, 356:802–807.

    Article  PubMed  CAS  Google Scholar 

  52. Sun H-C: Preventive treatments for recurrence after curative resection of hepatocellular carcinoma: a literature review of randomized control trials. World J Gastroenterol 2003, 9:635–640.

    PubMed  CAS  Google Scholar 

  53. Lau WY, Leung TW, Ho SK, et al.: Adjuvant intra-arterial lipiodoliodine-131 for resectable hepatocellular carcinoma: a prospective randomized trial. Lancet 1999, 353:797–801.

    Article  PubMed  CAS  Google Scholar 

  54. Muto Y, Moriwaki H, Ninomiya M, et al.: Prevention of second primary tumors by an acyclic retinoid, polyprenoic acid, in patients with hepatocellular carcinoma. N Engl J Med 1996, 334:1561–1567.

    Article  PubMed  CAS  Google Scholar 

  55. Chao Y, Li CP, Chau GY, et al.: Prognostic significance of VEGF, bFGF, and angiogenin in patients with resectable hepatocellular carcinoma after surgery. Ann Surg Oncol 2003, 104:355–362.

    Article  Google Scholar 

  56. Jia WD, Xu GL, Xu RN, et al.: Octreotide acts as an antitumor angiogenesis compound and suppresses tumor growth in nude mice bearing human hepatocellular carcinoma xenografts. J Cancer Res Clin Oncol 2003, 129:327–334.

    Article  PubMed  CAS  Google Scholar 

  57. Kouroumalis E, Skordilis P, Thermos K, et al.: Treatment of hepatocellular carcinoma with octreotide: a randomized controlled study. Gut 1998, 42:442–447.

    Article  PubMed  CAS  Google Scholar 

  58. Patt YZ, Hassan MM, Lozano RD, et al.: Durable clinical response of refractory hepatocellular carcinoma to orally administered thalidomide. Am J Clin Oncol 2000, 3:319–321.

    Google Scholar 

  59. Shiota G, Okubo M, Noumi T, et al.: Cyclooxygenase-2 expression in hepatocellular carcinoma. Hepatogastroenterology 1999, 46:407–412.

    PubMed  CAS  Google Scholar 

  60. Koga H, Sakisaka S, Ohishi M, et al.: Expression of cyclooxygenase-2 in human hepatocelluar carcinoma: relevance to tumor dedifferentiation. Hepatology 1999, 3:688–696.

    Article  Google Scholar 

  61. Bae SH, Jung ES, Park YM, et al.: Expression cyclooxygenase-2 in human hepatocelluar carcinoma and growth inhibition of hepatoma cell lines by a cox-2 inhibitor, NS-398. Clin Cancer Res 2001, 7:1410–1418.

    PubMed  CAS  Google Scholar 

  62. Kern MA, Schubert D, Sahi D, et al.: Proapoptotic and antiproliferative potential of selective cyclooxygenase-2 inhibitors in human liver tumor cells. Hepatology 2002, 36:885–894.

    PubMed  CAS  Google Scholar 

  63. Hu KQ, Yu CH, Mineyama Y, et al.: Inhibited proliferation of cyclooxygenase-2 expressing human hepatoma cells by NS-398, a selective COX-2 inhibitor. Int J Oncol 2003, 4:757–763.

    Google Scholar 

  64. Ito Y, Takeda T, Sakon M, et al.: Expression and clinical significance of erb-B receptor family in hepatocellular carcinoma. Br J Cancer 2001, 18:1377–1383.

    Article  Google Scholar 

  65. Kira S, Nakanishi T, Suemori S, et al.: Expression of transforming growth factor alpha and epidermal growth factor receptor in human hepatocellular carcinoma. Liver 1997, 4:177–182.

    Google Scholar 

  66. Matsuo M, Sakurai H, Saiki I: ZD1839, a selective epidermal growth factor receptor tyrosine kinase inhibitor, shows antimetastatic activity using a hepatocellular carcinoma model. Mol Cancer Ther 2003, 2:557–561.

    PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Division of Gastrointestinal Oncology, University of California at San Francisco School of Medicine, UCSF Medical Center, 1600 Divisadero, Box 1705, 94115-1610, San Francisco, CA, USA

    Jill Allen MD & Alan Venook MD

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  1. Jill Allen MD
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  2. Alan Venook MD
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Allen, J., Venook, A. Hepatocellular carcinoma: Epidemic and treatment. Curr Oncol Rep 6, 177–183 (2004). https://doi.org/10.1007/s11912-004-0047-9

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